Individual
MRS. SUZANNE A LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 SELMA AVE, WEBSTER GROVES, MO 63119-3107
(314) 918-4281
Mailing address
9307 OLD BONHOMME RD, SAINT LOUIS, MO 63132-4310
(314) 570-7720
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2000148174
MO
101YS0200X
School Counselor
Primary
2000148174
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194999045
—
MO
Enumeration date
04/22/2008
Last updated
10/05/2018
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